Recurrent pyogenic cholangitis: 'sump syndrome' following choledochoduodenostomy.

Abstract

An uncommon and late complication of side-to-side choledochoduodenostomy (CDD), the 'sump syndrome', developed in a patient 4 years after surgery. Recurrent right upper abdominal pain, fever with chills and rigors and latterly, mild jaundice made her seek repeated hospital admissions which were treated successfully with antibiotics. During the last admission, ultrasonography, endoscopic retrograde cholangiography (ERC), computerized scanning (CT) and hepatic iminodiacetic acid (HIDA) scan using Tc99m confirmed multiple intrahepatic calculi with proximal dilatation, debris in the distal blind segment and delayed excretion through the CDD. At surgery, the choledochoduodenostomy was taken down and a Rouxen-Y hepaticojejunostomy (RHJ) was fashioned after ductal clearance. The closed end of the Roux loop was placed subcutaneously for subsequent percutaneous access for cholangiography and removal of calculi. She is asymptomatic and well 28 months after surgery.

• Authors: T F Khan, Z A Sherazi, S Muniandy, M Mumtaz
• Journal: Tropical doctor (Trop Doct) Vol. 27 Issue 1 Pg. 51-2 (Jan 1997) ISSN: 0049-4755 [Print] England
• PMID: 9030026 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Bile Ducts, Intrahepatic (surgery)
• Cholangitis (etiology, surgery)
• Choledochostomy (adverse effects)
• Cholelithiasis (surgery)
• Common Bile Duct (surgery)
• Female
• Gallstones (surgery)
• Humans
• Recurrence